CEO of Missoula's Providence St. Patrick Hospital, Joyce Dombrouski, said on Monday that her hospital joins others in Montana in its concern over the possible reductions in Medicaid contained in the newest Republican healthcare plan.

"Our biggest concern really is the impact on Medicaid," said Dombrouski. "We don't believe that the revised Senate bill appears to make positive changes to the Medicaid program. As we go through our data, at first glance, it looks like 77,000 Montanans may lose Medicaid coverage in 2024. We know that a lot of those 'phase-ins' in the federal match are not very clear yet, but it just doesn't feel like it's going to be very helpful for the Medicaid folks in the state of Montana."

Dombrouski said she also has concerns for those who are covered by the healthcare exchange.

"There are 54,000 Montanans on the exchange, " she said. "It looks like the subsidies are trimmed, but we're still unclear what the full impact is. However, we have gone on record with Senator Daines and Senator Tester urging them to vote against the revised proposal. Our CEO recently went on national media and offered to work with the Trump administration on making enhancements in what could have been done earlier in the ACA."

Dombrouski said her main concern, aside from all the politics, is that patients in western Montana will have access to affordable health insurance coverage.

"We really want people to be able to access to healthcare and get covered," she said. "Whether it's the exchanges or on Medicaid, we believe that if individuals have coverage, that creates access for them to take advantage of the preventative side of healthcare that we long for them to have access to. If individuals have access to a primary care provider who is coordinating their healthcare effectively, they will have fewer crises and they won't have to resort to high cost options, such as the emergency room."

Dombrouski said the focus from the management of Providence is on Medicaid and the Montana healthcare exchanges in the new Senate bill.